Before developing diabetes, many people go through a stage called prediabetes, where blood sugar levels are higher than normal but not yet high enough for a diabetes diagnosis. Being told you have prediabetes can feel alarming, but the good news is that with early lifestyle and diet changes, you can often reverse it and prevent progression to type 2 diabetes. Think of prediabetes as your body’s early warning signal — an opportunity to take action. Let’s explore everything you need to know to manage and overcome prediabetes.
Table of Content
What Is Prediabetes?
Prediabetes is a transitional stage where blood sugar is above the normal but has not reached the diabetes threshold. Other terms for prediabetes include:
- impaired fasting glucose (IFG)
- impaired glucose tolerance (IGT)
- non-diabetic hyperglycemia
- intermediate hyperglycemia
According to the International Diabetes Federation, an estimated 635 million adults aged 20-79 years are living with prediabetes, translating to a 12% prevalence in 2025.
Fasting blood sugar is often measured to diagnose prediabetes:
- Normal fasting blood sugar: <100 mg/dL or 5.6 mmol/L
- Prediabetes: 100 – 125 mg/dL or 5.6 – 6.9 mmol/L
- Diabetes: <126 mg/dL or 7.0 mmol/L
What Is the Cause of Prediabetes?
The main cause of prediabetes is insulin resistance, the same underlying problem as in type 2 diabetes. It happens when your cells don’t respond properly to insulin. Over time, this can lead to higher blood sugar levels and eventually type 2 diabetes if the imbalance persists.
Am I at Risk of Prediabetes?
You may have a higher risk of prediabetes if you:
- Are physically inactive
- Have high blood pressure (> 140/90 mmHg)
- Have a history of heart disease
- Have polycystic ovary syndrome (PCOS)
- Had gestational diabetes during pregnancy
- Have triglycerides > 250 mg/dL or HDL cholesterol < 35 mg/dL
- Have an immediate family member with diabetes
- Previously tested with HbA1c > 5.7% or abnormal fasting glucose
- Show signs of insulin resistance (e.g., obesity, acanthosis nigricans)
Symptoms of Prediabetes
Most people with prediabetes are unaware of it and mostly don’t exhibit any symptoms. For those who show, symptoms are similar to those of type-2 diabetes, including:
- Increased hunger and thirst
- Frequent urination
- Blurred vision
- Fatigue
- Tingling in the feet
- Itchy skin
- Slow-healing woulds
If you experience the above symptoms, consult your doctor or general practitioner. They may suggest testing to confirm your condition and recommend the appropriate measures to cope with it.
Complications of Prediabetes
If left unmanaged, prediabetes will develop into Type 2 diabetes. When you have type 2 diabetes, your risk of the following complications will increase:
- Heart attack and stroke / cardiovascular disease
- Eye issues / diabetic retinopathy
- Foot problems that may result in amputation
- Kidney problems
How Often to Check Your Blood Sugar
If you meet the following conditions, it is recommended to have regular blood sugar checks to help you detect and treat high blood sugar levels early:
- Having two or more diabetes risk factors
- Have a BMI ≥ 24
- Aged 45 or older
Common methods for blood sugar checks include:
- Fasting blood sugar
- 75g oral glucose tolerance test (OGTT)
- HbA1c test
If the screening results already indicate prediabetes, an annual follow-up is recommended.
Without regular screening, high blood sugar often goes unnoticed. When the aforementioned symptoms appear, diabetes may already have developed.
Three Habits to Reverse or Lower the Risk of Prediabetes
Having prediabetes means your body’s blood sugar regulation is already struggling. According to the American Diabetes Association (ADA) 2023 Standards of Care, lifestyle modifications are the most effective way to reverse or lower your risk. Let’s start with three key habits.
Build Healthier Eating Habits
Here are some guidelines to improve eating habits:
- Aim for a balanced diet that works for you, so that you can stick to it
- Reduce saturated fats (like lard or fatty cuts of meat)
- Reduce amount of carbs and choose whole grains and other fiber-rish foods
- Limited consumption of added sugars to less than 5-10% of daily calories (WHO recommendation)
For example, with a 1,500 kcal diet, added sugar should account for only 150 kcal, which is about 38g. A bottle of carbonated soft drinks may already exceed that. It is therefore important to be mindful of what you consume.
Form an Exercise Routine
Exercise can help reduce insulin resistance, decrease abdominal obesity, and lower body fat percentage. If you are in the prediabetes stage or belong to a high-risk group for diabetes, aim for at least 150 minutes of moderate-intensity exercise per week. For example, walk 20-30 minutes after each meal or 10 minutes after each if you have a tight schedule.
Maintain a Healthy Weight
Obesity can increase insulin resistance and lead to diabetes. A BMI over 24 is considered overweight, while 27 and above is classified as obese. According to the American Diabetes Association, reducing body weight by 7% for overweight individuals can effectively lower the risk of developing diabetes.
Focus on sustainable lifestyle habits, combining healthy eating and regular exercise, to achieve gradual, long-term weight loss without regaining it.
What to Do When You Learn You Have Prediabetes?
- Educate yourself:
Learn what prediabetes means, the risks & causes, and changes needed to reverse it
- Take actions:
Prioritize diet, exercise, and weight management. Early intervention is key when it comes to overcoming prediabetes
- Prepare yourself mentally:
You may feel down or shocked when you first learn that you have prediabetes. It’s therefore important to mentally prepare yourself and understand that changes take time and patience. Set realistic goals and take one step at a time. It’s also important to build a support system along your journey.
- Seek support:
Consult healthcare professionals, use an app to track your progress, and seek support from family and friends for encouragement.
It Is Never to Late to Take Actions
Being diagnosed with prediabetes is not a sentence, but a wake-up call. By starting to monitor your blood sugar, weight regularly and adopt healthier lifestyle habits, it is possible to get your blood sugar levels back to normal. Just remember that small, consistent steps can prevent diabetes tomorrow.
References
- Standards of Medical Care in Diabetes- 2017; American diabetes association
- Prevention or Delay of Type 2 Diabetes and Associated Comorbidities: Standards of Care in Diabetes—2023; American diabetes association
